A Kildare woman, who was classified as being a high-risk patient for falls, suffered a fatal head injury as a result of a fall while she was unattended in a smoking area of a hospital, an inquest had heard.
Jennifer Foy, a 54-year-old mother of one from Pluckerstown, Kilmeague, Co Kildare, died at Beaumont Hospital on July 3rd, 2020.
An inquest into her death on Thursday heard Ms Foy had been transferred to Beaumont for surgery after suffering a blood clot in her head from a fall 11 days earlier while she was a patient at Naas General Hospital.
The inquest heard there was a dispute between the hospital and the deceased’s relatives over whether Ms Foy had signed a disclaimer at Naas General Hospital to take responsibility for anything which might happen if she left her ward against medical advice for a cigarette.
A sitting of Dublin District Coroner’s Court also heard evidence that Ms Foy’s family felt they were not listened to by doctors at Naas General Hospital and had difficulties trying to speak to them.
A clinical nurse manager at the hospital, Emma Dunne, gave evidence that Ms Foy insisted on going outside for a cigarette against medical advice.
Ms Dunne told the inquest that Ms Foy had been argumentative with staff on the morning of June 22nd, 2020 when she wanted to leave her ward to go to the hospital’s smoking area.
She pointed out that the patient, who had been admitted after suffering a fall at home three weeks earlier, had used a rollator to move around the hospital.
The nurse said she had advised Ms Foy she should return to her bed but the patient was adamant about going outside for a cigarette and would not wait for a wheelchair to become available.
The inquest heard it was decided that a care assistant would accompany her to the smoking area and would collect her again about 20 minutes later.
Ms Dunne said she subsequently heard that Ms Foy had been brought to the hospital’s emergency department after she had collapsed and fallen on the ground in the smoking area.
The inquest heard she was transferred the following day to Beaumont Hospital for surgery.
Questioned by the coroner, Aisling Gannon, Ms Dunne said her concern was that it was unsafe for the patient to leave the ward unaccompanied.
She said she had asked a care assistant, Helen Newsome, to bring the patient down to the smoking area as she believed Ms Foy might otherwise have tried to leave the ward on her own which she claimed would have been “an unsafer option.”
In evidence, Ms Newsome said Ms Foy had been in an agitated state and had been screaming and shouting about wanting to go for a cigarette.
However, she said Ms Foy had joked with her outside in the smoking area about being “like a naggy mammy” when she instructed the patient to “be safe” until she returned to collect her.
A hospital consultant, Ion Cretu, claimed there were elements of what he described as “a very unfortunate sequence of events” which were “beyond our control.”
Dr Cretu stated that Ms Foy’s “persistence in smoking” while in hospital had led to “this tragic event.”
The consultant said he had “stern conversations” with the patient during several of her admissions to Naas General Hospital about leaving the ward unaccompanied to go outside smoking.
Dr Cretu said he had informed her that it would be her own responsibility if suffered a fall if she left her ward on her own.
On his instructions, Dr Cretu said a junior doctor had spoken to Ms Foy’s family shortly after her final admission to claim the issue was becoming a problem.
Fall at home
The deceased’s husband, Tom Foy, said his wife had initially been brought to hospital in Naas on June 3rd, 2020 after she had suffered a fall in the bathroom in their home.
Mr Foy told the coroner that he felt his concerns about his wife’s deteriorating condition had not been listened to by staff at Naas General Hospital and said he had made numerous attempts to speak to the medical team looking after his wife.
Mr Foy said he had conveyed his concerns to nurses who said they would pass them on to doctors but he never received any return call.
“I think that if someone had spoken to me, we might not be here today,” Mr Foy remarked.
He recalled that he was concerned that his wife’s health was “going dramatically downhill” since June 12th, 2020 and she was having difficulty in holding a cup of tea and cigarette and could not feed herself.
“I kept saying I think there is something more wrong but I felt I was not listened to,” said Mr Foy.
The hospital’s director of nursing, Anne Murphy, said a review of Ms Foy’s case had resulted in a change in its falls policy that rollators should not be used as a mode of transport for use with patients.
Ms Murphy said staff would also accompany patients on smoking breaks so long as the care of other patients would not be compromised.
Following Ms Foy’s death, the nursing director said hospital staff were “more cognisant” that patients who smoke cannot just stop as it is an addiction.
The inquest heard post-mortem results showed Ms Foy had died as a result of a blood clot in her head which has resulted from the fall at Naas General Hospital as well as complications from previous head injuries and a complex medical history.
Returning a narrative verdict, Ms Gannon offered her condolences to Ms Foy's family on her tragic death.